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Communlcable

ulseases
Þrepared byť Marlon lŦ Manzaresţ 8n
1eLanus
1eLanus
AkAť Lock !aw

CausaLlve AgenLť ClosLrldlum 1eLanl

Þredlsposlng facLorsť

lncubaLlon perlodť 3Ŵ10 days buL may vary from
2days Lo several weeks


Mode of Lransmlsslon
Ŵbreak ln skln lnLegrlLy
ManlfesLaLlonť

ŴSLlffnessŤ neckţ [aw musclesţ abdomenţ llmbsŦ
Ŵ1he llps proLrude and Lhe corners of Lhe mouLh
are drawn ouL of shape
ŴCplsLhoLonos
Ŵ PypersenslLlvlLy
Ŵ Low grade fever buL profuse sweaLlng ls
common
ŴdlfflculLy of breaLhlng or swollowlng
Ŵ CyanoLlc
Ŵmay have urlnary reLenLlon ad consLlpaLlon
ManagemenL
ÞrevenLlon
AcLlve lmmunlzaLlon
Þasslve lmmunlzaLlon (AnLlLoxln)
ConLrol
Medlcal AsepLlc Lechnlque
ConcurrenL dlslnfecLlon
1ermlnal dlslnfecLlon
1reaLmenL
Medlcal careŴ ob[ecLlves

neuLrallze Lhe Loxln
klll Lhe mlcroorganlsm
ÞrevenL and conLrol spasm
Muscle relaxanLŴ meLhocarbamol (raboxlnţ
robaxlsal)ţ 8aclofen
SedaLlvesŴ vallum
1ranqulllzersŴ 1horazlne
1racheosLomyţ lf needed
nurslng Care
ÞaLlenL should be ln quleLţ darkenedţ wellŴ
venLllaLed room and nonŴsLlmulaLlng room
Mlnlmal/ genLle handllng of paLlenLŦ
Llquld dleL of 3000Ŵ4000 calorles vla Lube
feedlngs lf needed
ÞrevenL ln[ury
Þroper wound care
MenlnglLls
MenlnglLls
AkAť SpoLLed lever

CausaLlve AgenLť Menlngococcus nelsserla
MenlnglLldes

Þredlsposlng facLorsť
Any age buL prlnclpally ln chlldren (under 10
yrs) and young adulLs
Cold weaLher

lncubaLlon Þerlodť 7 days ave

Mode of Lransmlsslonť uropleL (nasopharynx)

ulagnosLlc/ LaboraLory Lxam
LeukocyLosls
+ noseţ LhroaLţ blood and splnal fluld culLure
Splnal lumbar Lap
Slgns and sympLoms
lnLense Pead ache
Chllls
lever
vomlLlng (pro[ecLlle)
Þaln (eyes)Ŵ wlLh LlghL
nuchal rlgldlLy
CplsLhoLonos
Convulslons
lnCŦ lCÞ


CompllcaLlon

Pydrocephalus
Þneumonla
CLlLls Medlaţ MasLoldlLls
Con[ucLlvlLlsţ bllndness due Lo opLlc aLrophy
Cralnlal uamage
ManagemenL
ConLrolŴ Þroper dlsposal of nasopharyngeal
secreLlonsŤ use of mask
1reaLmenLť
Medlcal careť Lqual parL of Sulfadlazlne and
Sulfamerazlne
CnS lnfecLlonŴ uexameLhaasoneŤ Þenlclllln lv
SedaLlves
CorLlcosLerolds
MannlLol lf wlLh lnc lCÞ
nurslng ManagemenL
Malnly SupporLlve
uarkenedţ nonsLlmulaLlng envlronmenL wlLh
mlnlmal handllng

Þroper poslLlonlng
llaL on bed lf wlLh nuchal rlgldlLy
Sldelylng poslLlon lf oplsLhoLonlc
LnCLÞPALl1lS
LncephallLls
CausaLlve AgenLť

Þrlmary
Arbovlruses (eŦg SLŦ Loulseţ AusLrallan x

Secondary
AcuLe supuraLlve

1oxlc
MeLal polsonlng
LncephallLls
ulagnosLlc/ LaboraLory exams

Lumbar Lap

LlecLroencephalogram (LLC)Ŵ
Slgns and SympLoms
SAML AS MLnlnCl1lS
AlLered level of consclousness
Cranlal nerve palsles parLlculary oculomoLor
nerves resulLlng ln dlploplaŤ pLosls
Pead ache
nausea
Malalse
Convulslons
Severe vomlLlng
Plccups
Slgns and SympLoms
ulsLurbances ln swollowlng

When asleepţ face has a pecullarly
expresslonless ans unwrlnkledţ maskŴllke
appearance
ManagemenL
ÞrevenLlonť uCP CLLAn Þ8CC8AM

ConLrolť by Medlcal asepsls
1reaLmenL
Largely sympLomaLlc/ SupporLlve

Medlcal careť
SedaLlves
Splnal Lap
AnLlbloLlcs

nurslng Care
CuleLţ darkenedţ nonsLlmulaLlng envlronmenL

Sklnţ oral and nasal hyglene

Lye care
ÞollomyellLls

AkA

Þollo

lnfanLlle paralysls

lncubaLlon Þerlod
Ŵ 6 Lo 20 days
CausaLlve AgenL
Þollovlrus (Þv) / Leglo ueblllLans
Mode of Lransmlsslon
uropleL lnfecLlonŴ early sLage

8ody secreLlonsŴ nasopharyngeal

lecalŴ oralŴ durlng laLe sLage
Slgns and SympLoms
Mlnor SympLoms (mlnor pollo)Ŵrecovered
wlLhln 72 hours

upper resplraLory LracL lnfecLlon (sore LhroaL
and fever)ţ

CasLrolnLesLlnal dlsLurbances
(nauseaţ vomlLlngţ abdomlnal palnţ consLlpaLlon
orţ rarelyţ dlarrhea)
Slgns and sympLoms
Ma[or pollo

AcuLe flaccld paralyslsŦ

Þoker's splne

Poyne's slgn
Þredlsposlng lacLors
Chlldren below 10 years old

Male more ofLen affecLed


Þoor envlronmenLal sanlLaLlon and hyglenlc
condlLlon
ulagnosLlc/ LaboraLory Lxam

Lumbar LapŴ (+) Þandy 1esL

Muscle 1esLlng

SLool Lxam
ManagemenL



Þasslve lmmunlzaLlon


AcLlve lmmunlzaLlon
nurslng lnLervenLlon
SupporLlve

PeaL appllcaLlon for spasms

AlrwayŤ LracheosLomy

llulds

LnLerlc and sLrlcL precauLlons
uLnCuL lLvL8
Also known As

8reakbone lever

uandy leverţ

CausaLlve AgenL
Arbovlruses (parLlcularly flavlvlrus)

Common durlng ralny season
lnfanLs and school chlldren are mosLly affecLed
generally 0Ŵ9 years old age group

lncubaLlon perlodŴ 3 Lo 10 days afLer Lhe blLeŦ

CausaLlve agenL
MosqulLo 8lLe

Aedes aegypLl (female)
Aedes alboplcus
CulLex faLlgans

uay blLlngţ low flylng
8reeds on clearţ sLagnanL waLer
Pas gray wlngs and whlL sLrlpes on Lhe body

ManlfesLaLlon

ÞlaLeleL counL ƹ0Ŧ37Ŵ 0Ŧ34Ŵ because of
hemoconcenLraLlon
ManlfesLaLlon
Crade 1

+ 1ournlqueL LesL
Sudden hlgh fever for 3 Lo 7 days
sore LhroaL
8edness of Lhe eye balls
Swollen face
Þaln
Perman's slgn
Macular or measlesŴllke rash
ManlfesLaLlon
Crade 2
Crade 1 +bleedlng

LplsLaxls
CasLrlc 8leedlng
PemaLemesls
Mellna
PemaLochezla
Clnglval bleedlng
Coffee Cround vomlLus

ManlfesLaLlon
Crade 3

Crade 2 + clrculaLory collapse

PypoLenslon
Cold clammy skln
Weak Lhready pulse
very rapld resplraLlon

ManlfesLaLlon
Crade 4

Crade 3+shock (due Lo excesslve bleedlng)Ť
uLA1P lf unconLrolled

ManagemenL

MonlLor bleedlng
Cold compress
Lplsaxlsť lean forward
Clnglval bleedlngŤ lce chlps
PemaLemeslsŤ nÞC

1reaLmenL
AnLlpyreLlcţ excepL ASA

CoagulanLs
vlLamln C
8lood 1ransfuslon
nurslng Care


C88
uleL
ÞrevenLlng and conLrol bleedlng
Shock
LaboraLory
1ournlqueL LesL/ rumpel lead LesL
PemaLocrlL
CloLLlng bleedlng Llme (3 serles ln 8 hours)
ÞlaLeleL counL
uengue 8loL 1esL
nurslng dlagnosls
lluld volume deflclLţ shock

lnLervenLlon

MonlLor for slgns of bleedlng and fall ln blood
pressure and ÞlaLeleLs
MALA8lA

CausaLlve AgenLŴ ÞroLozoan paraslLe

Þlasmodlum vlvax
Þlasmodlum falclparumŴ can be faLal
Ŵ8lack colored urlneŴ due Lo rapld breakdown of
88C
Ŵcerebral hypoxlaŤ resLlessnessţ confuslonţ
deluslonţ convulslonţ loss of consclousness and
comma
Þlasmodlum malarlae
Þlasmodlum ovale

ulagnosLlc/ LaboraLory Lxams
Malarla SmearŴ Lhe besL Llme Lo wlLhdraw blood
sample ls durlng Lhe helghL of Lhe fever

CuanLlLaLlve 8uffy CoaL (C8C)Ŵ rapld LesL
whereln blood ls exLracLed even wlLhouL fever

Slgns and SympLoms
Cold sLageŴ for 10Ŵ13 mlnuLesŦ Chlllsţ shlvers
and shakesŤ cool skln

PoL sLageŴ 4Ŵ6 hoursŦ 8ecurrlng hlgh feverŤ
severe headacheţ nausea and vomlLlngŤ
abdomlnal palnŤ face ls blue and plnched

ulaphoreLlc sLageŴ excesslve sweaLlng whlch
beglns around Lhe hand Lhen Lhe enLlre body
afLer Lhen feverŤ weaknessŤ pallor
*CompllcaLlonsŤ damage Lo Lhe bralnţ llver and
spleen

ManagemenL
ÞrevenLlon

CLLAn program of uCPŤ prophylacLlc drugŤ use
of mosqulLo neLs

ConLrolŴ fumlgaLlon

1reaLmenL
Medlcal Care
anLl malarlal drugs
Culnlne
Aralen (cloroqulne)
Þrlmaqulne
Þansldan
ALabrlne
nurslng care
uurlng cold sLageŴ provlde blankeLţ warm
drlnksţ warm baLh

uurlng hoL sLageŴ Lepld sponge baLhţ alcohol
rubţ cold compressţ llghL loose cloLhlng

uurlng dlaphoreLlc sLageŴ keep paLlenL dryţ
lncrease fluld lnLake

LLÞ8CS?
LLÞ8CS?
AkAť PAnSLnƌS ulSLASLŤ PAnSLnCSlSţ LLÞ8A
ls an anclenL dlsease and ls leadlng cause of
permanenL physlcal dlsablllLy
A chronlc dlsease LransmlLLed from man Lo man
affecLlng Lhe sklnţ mucous membrane and
nervous LlssueŦ
no new case of leprosy arlses wlLhouL prevlous
conLacLŤ usually prolonged and lnLlmaLeŦ
CausaLlve AgenL
MycobacLerlum leprae/ hansesƌs baclllus

ManlfesLaLlons
Cardlnal Slgns

loss of sensaLlon/ locallzed anesLhesla
poslLlve smear LesLŤ presence of hansen's bacllllŦ
Larly ManlfesLaLlon
color changes ln Lhe skln whlch does noL
dlsappear even wlLh LreaLmenL
skln ulcers whlch does noL heal wlLh LreaLmenL
paln and redness of Lhe eyes
nasal obsLrucLlon and nose bleedlng
muscle weakness and paralysls
loss of sensaLlon on Lhe affecLed area
loss of halr growLh
anhydroslsŴ loss of sweaLlng
alopecla
LaLe ManlfesLaLlon
LagopLhalmosŴlnablllLy Lo close Lhe eyellds
MadaroslsŴloss or absence of eyebrows
Slnklng of brldge of Lhe nose
Leonlng faceŴ skln becomes Lhlckened and
nodular
ConLracLuresŴ clawlng of flngers and Loes
Chronlc skln ulcers
CynecomasLla

llnal SLage

ln[ury of Lhe eye
naLural ampuLaLlonŴ Loes flngersţ earţ and nose

LaboraLory uaLaŤ skln smear LesLţ skln leslon
blopsyŤ
Lepromln 1esLŴ deLermlne suscepLlblllLy/
reslsLance
Wassermann reacLlon LesL
Mode of 1ransmlsslonŤ (noL exacLly known) skln
Lo skln conLacLŤ dropleL lnfecLlon(resplraLory
LracL)
lncubaLlon perlodŤ 1Ŵ3 years
Þerlod of CommunlcablllLyŤ as long as Lhere are
open leslons

nurslng ulagnoslsŴ body lmage dlsLurbance

*chlldren below12years old are more
suscepLlble

ÞrevenLlon
SeparaLe lnfanLs from LepromaLous parenLs aL
blrLh
8CC lmmunlzaLlon
Avold conLacL

MulLl urug 1herapyŴ Sulfone drugs are glven ln
comblnaLlon wlLh drugs Lo prevenL reslsLanceţ
hasLen recovery and lessen Lhe perlod of
communlcablllLy

ÞAuCl8AClLLA8? (few mlcroorganlsms)Ŷ Clven
for 6Ŵ9 monLhs or unLll negaLlve
8llAMÞlCln
boLh Laken orally once a monLh
uAÞSCnL dally

MuL1l8AClLLA8? (many mlcroorganlsms)Ŵ glven
for 24Ŵ30 monLhs

3 drug comblnaLlon
8lfamplclnŴ once a monLh
uAÞSCnL + LAMÞ8LnL dally

*AL Lhe end of Lhls duraLlonţ Lhe paLlenL should
be consldered as LreaLmenL compleLed (1C)
*Leach paLlenL abouL slde effecLs and adverse
effecL of medlaLlonŦ


8LlAMÞlCln
dlscoloraLlon of body flulds
rashes
muscle soreness
anurla (nephroLoxlclLy)
LhrombocyLopenla
[aundlce (hepaLoLoxlcly)

uAÞSCnL
causes lncrease ln Lhe numbers of leslons
relaLed sympLomaLlcallyţ needs referral

LAMÞ8LnL
skln dlscoloraLlon
dryness and flankness of Lhe skln (hoL soak Lo
lmprove clrculaLlon)


nurslng lnLervenLlon
LmoLlonal SupporL
CorrecL MlsconcepLlon
8alanced uleLţ Lxerclseţ 8esL Pyglene
MeLlculous Lye Care
Skln Care
Þasslve and acLlve exerclses Lo prevenL
conLracLures
AdequaLe lnformaLlon regardlng drug Lherapy

LLÞ1CSÞl8CSlS

Also known AsŤ

WLlL'S ulSLASLţ Muu lLvL8ţ
WlnLPL8uƌS ulSLASL

*1hls lnfecLlon ls carrled by anlmals and caused
by LLÞ1CSÞl8A ln1L88CCAnS


MAnllLS1A1lCn
Larly sLageŴ fever (40 degrees cenLlgrade)ţ
Lachycardlaţ skln warmţ flushedţ peLechlaeţ
myoslLls

Severe (mulLlorgan)Ŵ con[uncLlval suffuslonţ
[aundlceţ purpura A8lţ hemopLysls


LaboraLory uaLa
LA1 (lepLosplra aggluLlnaLlon LesL)
LAA1(lepLosplra anLlgen anLlbody LesL)
urlnalyslsţ C8Cţ Serology

nurslng ulagnosls
alerLed body LemperaLure Ť pyrexla
lnLervenLlon
uCx?C?CLlnL (vl88AM?lnŤ penlclllln g naţ
Mode of 1ransmlsslonŴ lngesLlonţ lnoculaLlon
lncubaLlon perlodŴ 6 Lo 13 days

ÞL81uSSlS
AkAŤ whooplng coughŤ 100Ŵday fever

CausaLlve AgenLŴ hemophllus perLussls

lncubaLlon ÞerlodŴ 7days

Þerlod of CommunlcablllLyŴ hlghly
communlcable ln Lhe early caLarrhal sLage
before Lhe proxlmal cough sLage
Mode of 1ransmlsslon
alrborne/dropleLŤ prlmary by dlrecL conLacL wlLh
dlscharges from resplraLory mucous membrane
o lnfecLed paLlenLsŦ

ulagnosLlc/ laboraLory examsŴ Lo lsolaLe
mlcroorganlsms from nasopharyngeal
secreLlons

agar plaLe
nasal swab
cough plaLe


Slgns and SympLoms
lnvaslon or caLarrhal sLageŴ 7Ŵ14Ŧ sLarLs as an
ordlnary codŤ waLery eyesţ sneezlngţ sllghL dry
lrrlLaLlve coughţ feverţ feels sllghLly below par

Spasmodlc or paroxysmal sLageŴ duraLlon ls 4Ŵ
12 weeks
3Ŵ10 spasms or paroxysyms of exploslve
coughlng (no Llme Lo caLch breaLh ln beLween)
followed by prolonged explraLlon and a sudden
nolsy lnsplraLlon wlLh a long hlgh plLched
ºwhoop" aL Lhe endť ÞaLhognomonlc slgn

lace geLs a dusky blulsh colorţ eyeballs seen Lo
proLrudeţ velns of he head and neck become
swollen and Longue may proLrude because of Lo
much exerLlon whlle coughlngŦ

lnvolunLary uefecaLlon
Pemorrhage of skln and oLher membranes ť
nose (eplsLaxls)ţ con[uncLlvaţ ears (can lead Lo
deafness)

ConvalescenL SLageŴ slgns and sympLoms
subslde
bronchopneumonla
abdomlnal hernla
severe malnuLrlLlon
18Ť asLhma
encephallLls


ManagemenL
ÞrevenLlonŴ lmmunlzaLlon (uÞ1) every 4Ŵ8
weeks for 3 successlve doses wlLh boosLers aL 3
and 6 years of age

ConLrolŴ lsolaLlonţ medlcal asepslsţ concurrenL
and Lermlnal dlslnfecLlon
1reaLmenL
Medlcal CareŴ Chloramphenlcol
(chloromyceLln)ţ 1erramyclnţ Þenlclllln

nurslng Care
C88 Lo conserve energy
prevenL asplraLlon
proper poslLlonlng
nÞC durlng aLLacks
Abdomlnal blnder Lo prevenL hernla
Plgh Calorleţ bland dleLŦ omlL mllk and mllk
producLs because lL lncreases mucousŦ

8efeedlng of lnfanLs musL be done 20 mlnuLes
afLer vomlLlng has occurredŦ

lormulas should be glven aL room LemperaLure
because hoL or cold flulds cause paroxysms of
coughlngŦ

8oLLle nlpple should be smallŤ dropper may be
used lnsLead


1u8L8CuLCSlS
one of Lhe mosL common communlcable
dlsease whlch Lends Lo run a chronlc courseŦ
badly nourlshedţ neglecLed and faLlgued
lndlvlduals are more prone Lhan Lhelr healLhler
counLerparLsŦ

AkAť koch's dlseaseŤ galloplng consumpLlon

CausaLlve agenLŤ mycobacLerlum Luberculosls
(Lubercle baclllus)

noL kllled by gasLrlc acld

Can galn access Lo Lhe body
1hrough resplraLory LracL lnhalaLlon
8y lngesLlon Lhrough Lhe mouLh and oral cavlLy
and absorpLlon Lhrough Lhe lnLesLlnal LracL
8arely Lhrough skln

lncubaLlon perlodŴ 4Ŵ12 weeksŴ acLually varlable
dependlng on Lhe Lype of dlseaseţ ageţ
reslsLanceţ eLcŦ
Þerlod of communlcablllLyŴ beglns when Lhe
leslon sLarLs dlscharglng Lubercle bacllll
(ºbecomes open") and conLlnues as long as Lhe
mlcroorganlsm ls dlscharged from Lhe body of
Lhe paLlenL
Mode of 1ransmlsslonŴ always conLacLed from a
person wlLh ºopen" Luberculous leslonŦ
spread by dlrecL or lndlrecL conLacL wlLh
lnfecLed persons usually by dlscharges from Lhe
resplraLory LracL by means of coughlngţ
sneezlngţ or klsslngŦ
uropleL lnfecLlon or by conLacL wlLh
conLamlnaLed eaLlng or drlnklng uLensllsţ flles
or dusLŦ
ConLamlnaLed mllk (mycobacLerlum bovls ln
caLLle)


ulagnosLlc/ laboraLory exam
SpuLum exam
ChesLŴ xray
1uberculln LesLŴ 0Ŧ1ml of purlfled proLeln
derlvaLlve (ÞÞu) ln[ecLed lnLradermally and
lnLerpreLed ln 48Ŵ72 hoursŦ lf no changeţ ls
negaLlveŦ poslLlve resulL (10mm lnduraLlon0
means prlmary Luberculous lnfecLlonŦ
ManLoux LesLŴ mosL advanLageous and accuraLe
1lne LesL/mulLlpuncure LesLŴ clrcular 6Ŵ8 Llmes
volmer and plrqueLŴskln scraLch/paLch LesL

ulagnosLlc ÞolnL

PlsLory of hemopLysls

Þresence of Lubercle bacllll ln Lhe spuLum

PlsLory of pleurlsy wlLh effuslon

xŴray evldence of leslon ln one or boLh upper
lung fleldsŦ
Slgns and SympLoms
cough for an unusually long Llme
afLernoon feverŤ nlgh sweaLs
anorexlaŤ welghL loss
exLreme faLlgueŤ malalse
backacheţ chesL paln
anemlaŤ amenorrhea
PemopLysls (coughlng ouL of blood0
ManagemenL
ÞrevenLlon
ÞrompL dlagnosls and LreaLmenL
8CC vacclnaLlon

ConLrol

Medlcal asepLlc Lechnlques

1reaLmenL
Medlcal careŴ shorL course chemoLherapy (SSC)Ŧ
use of mulLlple or comblnaLlon drugs ls meanL
Lo mlnlmlze adverse effecLs and prevenL
formaLlon of drug reslsLanL bacllll

8lfamplcln ( 8)
lsonlazld (l)
Þyrazlnamlde (Þ)
LLhambuLol (L)
SLrepLomycln (S)Ŵ lnLerferes wlLh Lhe
reproducLlve capaclLy of Lhe mlcroorganlsmŤ
can cause neuroLoxlclLyţ speclflcally Lhe 8Lh
cranlal nerveţ causlng deafness or verLlgo
8ecommended CaLegory of 1reaLmenL 8eglmen
CaLegory 1

new Smear + Þ18ţ
new smear (Ŷ) Þ18 wlLh exLenslve prenchymal
leslons on Cx8
lnLenslveť (2mos) 28lÞL
ConLlnuaLlon Þhaseť 4l8


CaLegory 2
1reaLmenL lallure
8elapse
8eLurn afLer uefaulL

lnLenslveť (3mos)Ť flrsL 2mosţ 28lÞLS
3rd monLhţ 38lL
ConLlnuaLlon Þhaseť 3mosţ 38lL

CaLegory 3

new Smear (Ŷ) Þ18 wlLh mlnlmal parenchymal
leslon on Cx8
lnLenslve Þhaseť (2mos)ţ 28lÞL
ConLlnuaLlon Þhaseť 4l8
CaLegory 4

Chronlc (SLlll smear poslLlve afLer reŴLreaLmenL)
*8efer Lo speclallzed faclllLy or uC1S Þlus
CenLer
nurslng Care
AdequaLe nuLrlLlon ls of CuLmosL lmporLanceŦ








1?ÞPClu LvL8
AkAŤ enLerlc fever

CausaLlve agenLŴ salmonella Lyphosa
lncubaLlon perlodŴ usually beLween 7Ŵ14 days
Þerlod of ÞommunlcablllLyŴ for as long as Lhe
bacLerla are ln Lhe sLools
Mode of 1ransmlsslonŴ by food and waLer
conLamlnaLlon y sLools and urlne of paLlenLs or
carrlersŦ Lhe vehlvles are Lhe 3 lƌs
Ŵfeces ŴfomlLes
Ŵfood Ŵflngers
Ŵflles

ulagnosLlc/ LaboraLory Lxams
8lood CulLureŴ durlng Lhe prodromal sLage

*wldalƌs LesL Lo deLermlne Lhe anLlgen lefL by
mlcroorganlsm
ŴanLlgen CŴ presenLly lnfecLed
ŴanLlgen PŴ Pas been exposed before or has
recelved Loxln

*Lyphold
urlne culLure

Slgns and SympLoms
Þrodromal sLageŴ 3Ŵ4 days
dull headacheŤ malalse
chlllsŤ feverŤ body aches
vomlLlng and dlarrhea
fasLgeal/pyrexlal sLageŴ durlng Lhe second week
exanLhemť rose spoLsŴ 4Ŵ3 pecullar roseŴcolored
macules or maculopapules seen ln Lhe 7Lh Lo
Lhe 12Lh day on Lhe abdomen and chesL (ln
adulLs) o on Lhe face (ln lnfanLs)
ladder llke fever
enlarged spleen
Lyphold psychosls
1yphold Þsychosls
CommaŴvlgll lookŴ puplls dllaLe and paLlenL
appears Lo have blank sLares or sLarlng wlLhouL
seelng
ulfflculLy puLLlng ouL Lhe Longue
CarphoglaŴ lnvolunLary and almless
Þlcklng of llnen
SubsulLus 1endlnumŴ lnvolunLary LwlLchlng of
Lhe Lendon of Lhe wrlsLs
ConsLanL 1endency Lo sllp down Loward Lhe
fooL of Lhe bed


ueferenscene SLageŴ 3rd week
lnLesLlnal PemorrhageŴ mlcroorganlsm
produces ulcers ln Lhe lnLesLlne
lnLesLlnal ÞerforaLlonŴ splllage of fecal maLerlal
ln Lhe perlLoneumţ causlng perlLonlLls
aŦ perslsLence fever
bŦ abdomlnal palnţ dlsLenslon and rlgldlLy
Cough and PyposLaLlc congesLlon of Lhe lungsŤ
pneumonla
Leukopenla
Lysls/ Convalencence sLageŴ alLhough slgns and
sympLoms subsldeţ paLlenL should sLlll be
observed for relapses whlch could be faLalŦ
ManagemenL
ÞrevenLlon
lmmunlzaLlonŴ Cu1 (CPCLL8Aţ u?SLn1L8?ţ
1?ÞPClu)
aŦ glven lM aL Lhe delLold
bŦ chlldrenŴ 0Ŧ23mlţ adulLsŴ 0Ŧ3 ml
6 monLhs lmmunlLy
vlvoLlf
Ŵcapsule form
Ŵglven 1 hour before meal every oLher day for 3
doses
Ŵ3 years lmmunlLy

ConLrol
aŦ proper hand washlngŤ clean envlronmenL
bŦ boll drlnklng waLer
cŦ avold sLreeL foods and lmproperly washed or
lmproperly cooked food

1reaLmenL
Medlcal CareŴ chloromyceLlnŤ drug of cholce
nurslng Care
regulaLlon of Lhe dleL
prevenLlon of dehydraLlon
hyglene and comforL
lCCu ÞClSCnlnC
CnseL ls usually abrupL and ascrlbed Lo food
recenLly eaLen
1he mosL common predlsposlng cause conslsLs
of lnfecLed food handles and lnsufflclenL
cooklng foodŦ
1he exoLoxln of boLuklsm ls a Lrue polson
known Lo be one of Lhe deadllesL subsLances
and usually released lnLo Lhe food shorLly afLer
lL has been canned and preservedŦ
Slgns and SympLoms
May vary among lndlvlduals dependlng on Lhe
reslsLance or Lhe amounL of lnfecLed food
eaLenŦ
AkAŤ SalmoneoslsŤ 8oLullsm

CausaLlve AgenL

SalmonelloslsŴ SŦ Lyphlmurlumţ sŦ cholerasesulsţ
sŦ MonLevldeoţ sŦ newporLţ sŦ Crangeburg
sLaphylococcus
8oLullsmŴ closLrldlum boLullnum
1oxln ls produced only under anaeroblc
condlLlon and alkallne or neural
Laslly desLroyed by bolllng

lncubaLlon perlodŴ 1/2/Ŵ48 hours


Þerlod of CommunlcablllLyŴ no secondary
personŴLoŴ person Lransmlsslon



Slgns and SympLoms
Salmonellosls
abrupL onseL and severe dlarrhea and
abdomlnal cramps
sLools are offenslve and puLrefacLlve aL flrsLţ
laLer becomlng waLeryţ greenlsh and bloodyŤ
Leems (sLralnlng aL sLool)
concurrenL dlarrhea and vomlLlngţ abdomlnal
LendernessŤ sllghL fever

8oLullsmŴ relaLlng prlmarlly Lo Lhe nervous
sysLem
exLreme weakness
dlfflculLy ln breaLhlngţ swallowlng and speaklng
marked verLlgoŤ dlsLurbances of vlslon

ManagemenL
ÞrevenLlonŴ proper cannlngŤ poLasslum ls a llfe
savlng measure
LreaLmenL of shock lf presenL
anLlbloLlcs

nurslng care
C88 and comforL measure

u?SLn1L8?
AkAť
baclllaryŴ shlnglloslsŤ bloody flux
choleraŴ Ll Lor
ameblcŴ ameblasls

CausaLlve AgenLŴ gram negaLlveţ
nonsporulaLlngţ nonmoLlle bacLerla
8aclllaryŴ shlngela dysenLerlaeŤ flexnerŤ boydllŤ
sonne
CholeraŴ vlbrlo commaŤ ogawaŤ lnabaŤ el Lor
AmeblcŴ enLamoeba hysLolysLlca

lncubaLlon ÞerlodŴ 4 Lo 7 days

Þerlod of CommunlcablllLyŴ durlng acuLe
lnfecLlon and unLll Lhe lnfecLlous agenL ls no
longer presenL ln Lhe sLoolţ usually wlLhln 4
weeks afLer lllnessŦ
Mode of 1ransmlsslonŴ by dlrecL or lndlrecL
fecal oral Lransmlsslon from a paLlenL or carrlerŦ
ulagnosLlc/ LaboraLory Lxam
SLool LxamŴ fresh sLool wlLh ln 30 mlns Lo one
hour should be examlned or Lhe presence of
LrophozolLes

8ecLal Swab
Slgns and SympLoms
8aclllary
ushered ln by chllls followed by fever
nauseaţ vomlLlngţ Lenesmus (consLanL bearlng
down sensaLlon ln Lhe recLum as Lhough Lhe
bowels musL moveŤ yeL when Lhey doţ no rellef
ls felL)
severe dlarrhea aL flrsL mucold and laLer bloodyţ
alLernaLlng wlLh consLlpaLlonŦ
bowel movemenLs may be 3Ŵ Lo 40 Llmes or
more ln 24 hours
exLreme LhlrsL and rapld dehydraLlon

Cholera

sLarLs wlLh acuLe chollcky palns ln Lhe abdomenţ
accompanled by mlld dlarrhea ln whlch sLools
are aL flrsL yellowlsh becomlng graylshŴ whlLe
(ºrlce waLery")Ŧ use of waLer bed ls necessary
because bowel movemenLs are very frequenLŦ
marked menLal depresslonţ headacheţ vomlLlng
fever may or may noL be presenL
exLreme LhlrsLţ Lhlckly furred Longueţ severe or
vlolenL cramps ln Lhe legs and feeL
face appears shlveledţ eyes sunken and Lhe skln
an ashŴ gray colorŦ
washerwomanƌs handŴ because of rapld
dehydraLlonŦ

Amoeblc

Þrlmary or lnLesLlnal

vomlLlngţ Lenesmusţ severe abdomlnal cramps
ularrhea alLernaLlng wlLh consLlpaLlonŤ sLools
are mucopurulenLţ foulŴsmelllng and wlLh
bloody sLreaks
SecondaryŴ lncldenL Lo Lhe mlgraLlon of amoeba
Lo oLher organsţ usually Lhe llver (hepaLlLls) and
Lhe bralnŦ

Medlcal ManagemenLŴ baslcally lv Lherapy

8aclllary and CholeraŴ AnLlbloLlcs

AmoeblcŴ anLlproLozoan agenL eŦgŦ aralenţ
meLronldazole

ÞaralyLlc Shellflsh Þolsonlng
a syndrome of characLerlsLlc sympLoms
predomlnanLly neurologlc whlch occur wlLhln
mlnuLes or several hours afLer lngesLlon of
polsonous shellflshŦ

vlcLlms who survlve Lhe flrsL 12 hours afLer
lngesLlon have a greaLer chance of survlval



AkAť red Llde

CausaLlve AgenLŴ Þyromldlum bahaense var
compressum

2000 varleLlesţ 30 of whlch become polsonous
afLer heavy ralnfall
Ŵcauses red Llde ln Lhe seas around manlla bayţ
Samarţ 8aLaan and Zambales

Commonly called plankLons
Loxlns are noL LoLally desLroyed by cooklng
lncubaLlon perlodŴ 30 mlnuLes Lo several hours
afLer lngesLlon of polsonous shellflsh (Lahongţ
Lalaba)

Mode of 1ransmlsslon
lngesLlon of raw r lnadequaLely cooked sea
foods speclally blvalved shellflsh or mollusks
durlng red Llde season

Slgns and SympLoms
numbness of Lhe face speclally around Lhe
mouLh

dlzzlnessŤ floaLlng sensaLlonŤ weakness

headacheŤ rapld pulseŤ vomlLlng

dlfflculLy of speech (aLaxla) and dlfflculLy of
swallowlng (dysphagla)

Llngllng sensaLlonţ paresLhesla an evenLual
paralysls of hands and feeL

1reaLmenL
lnduce vomlLlng

Lo weaken Lhe Loxlc of red Lldeţ glve coconuL
mllk and sodlum blcarbonaLe soluLlon durlng
Lhe early sLageŦ lf glven durlng Lhe laLe sLage wlll
make he condlLlon worse

MuMÞS
A generallzed sysLemlc lnfecLlon lnvolvlng Lhe
paroLld glands
usually occurs ln epldemlc for
a slngle aLLack causes permanenL lmmunlLy lf
boLh glands were affecLedŦ

AkAŤ lnfecLlous parLlLas
CausaLlve AgenLŤ paramyxo vlrous
lncubaLlon ÞerlodŴ 3Ŵ37 daysţ usually 18 days
Þerlod of CommunlcablllLyŴ beglns before Lhe
glands are swollen and remalns for an unknown
lengLh of Llme
Mode of 1ransmlsslon
dropleL lnfecLlon
dlrecL conLacL wlLh a person a person who has
Lhe dlsease or wlLh arLlcles ln Lhe envlronmenL
whlch have been freshly solled wlLh secreLlons
from nasopharynx Ŧ sallva ls Lhe mosL lnfecLlous
of all body secreLlons

Slgns and SympLoms
subslde ln 9 days
may be preceded by headacheţ malalseţ feverţ
loss of appeLlLeţ muscle aches
abrupL onseL of paln rlghL beneaLh Lhe ear
accompanled by soreness of Lhe [aw and some
sLlffness of Lhe neck
paln when chewlng or swallowlng
Lhe paroLld gland swells ln fronL of Lhe earlobeţ
Lhe angle of Lhe [aw and down Lhe neckţ
lncludlng Lhe whole cheekŤ area ls Lender and
doughy or hardŦ
CompllcaLlon
Lhe LesLes are ofLen affecLed because of lLs
predllecLlon for glandular sLrucLuresŦ
nearly 1/3 of males develop orchlLls whlch may
subslde qulckly lL LreaLed properly wlLh
anLlbloLlcs buL some develop compleLe aLrophy
of Lhe LesLes leadlng Lo sLerlllLy
masLlLls and edema of Lhe vulva can occur ln
addlLlon Lo Lhe lnvolvemenL of Lhe ovary ln
females (oophonlLls)
cenLral nervous sysLem lnvolvemenL may occur
buL endocadlLls ls rareŦ
ManagemenL
ÞrevenLlonŴ lmmunlzaLlon wlLh MM8 (measlesŴ
mumpsŴrubella) vacclne

ConLrolŴ proper dlsposal of secreLlonsŤ lsolaLlon

1reaLmenL
Medlcal Care

corLlsoneŴ 300Ŵ 400 mg lnlLlallyţ Lhen 100mgŦ
every 6 hours for 3Ŵ4 days
analgeslcs for paln

nurslng Care
afLer Lhe age of puberLyţ Lhe mosL lmporLanL ls
for Lhe paLlenL Lo remaln absoluLely qulL ln bed
unLll all fever and swelllng have dlsappeared for
aL leasL 4 days Lo prevenL compllcaLlons
(orchlLls and oophonlLls)Ŧ
males should use wellŴflLLlng supporLerţ or a
sllng beLween Lhe Lhlghsţ Lo prevenL Lhe pull of
gravlLy on Lhe LesLes and blood vesselsţ Lhus
mlnlmlzlng Lhe dangers of orchlLlsţ edema and
aLrophy
lce collar or cold compress over Lhe paroLld
glandsŦ
sofLţ bland dleLŤ sour foods or frulL [ulces cause
burnlng sensaLlonŦ
PLÞA1l1lS
CausaLlve agenLs

MlcroorganlsmsŴ bacLerlaţ vlrusesţ proLozoaţ
splrocheLes

Loo much alcohol

drug lnLoxlcaLlon

chemlcal lnLoxlcaLlon

1ypes
PepaLlLls A
AkAŤ lnfecLlous hepaLlLlsŤ caLarrhal hepaLlLlsŤ
epldemlc hepaLlLls
CausaLlve AgenLŴ 8nAŴ conLalnlng vlrous
Mode of 1ransmlsslonŴ food and waLer
conLamlnaLed wlLh feces or sallva of paLlenL
wlLh hepaLlLls a
fecalŴoral
oralŴoral
Þredlsposlng lacLors
food handlers
unsanlLary llvlng condlLlon
oralŴanal sex
lncubaLlon ÞerlodŴ 2Ŵ7 weeks
PepaLlLls 8
ŴMosL faLal
AkAŤ serum hepaLlLlsŤ homologous hepaLlLlsŤ
vlral hepaLlLls
CausaLlve AgenLŴ unAŴ conLalnlng vlrus
Mode of 1ransmlsslonŴ blood and oLher body
fluldsŤ percuLaneous/lnoculaLlon

use of conLamlnaLed needles
blood Lransfuslon
oralŴoral Lransmlsslon
sexual Lransmlsslon
verLlcal/LransplacenLal Lransmlsslon


Þredlsposlng lacLors
healLh workers
blood reclplenLs
drug addlcLs
promlscuous lndlvlduals/ mulLlple sex parLners

lncubaLlon ÞerlodŴ 6 weeks o 6 monLhs


PepaLlLls C
AkAŴ posL Lransfuslon hepaLlLls
CausaLlve agenLŴ hepaLlLls c vlrus
Mode of 1ransmlsslon
ŴpercuLaneousţ parLlcularly blood Lransfuslon
Þredlsposlng lacLors
paramedlcal Leams
blood reclplenLs
lncubaLlon ÞerlodŴ 2 weeks Lo 6 monLhs
PepaLlLls u
uormanL Lype of hepaLlLls
Can be acqulred only lf wlLh hepaLlLls b
Same mode of Lransmlsslonţ predlsposlng
facLors and lncubaLlon perlod as PepaLlLls 8
PepaLlLls L
lf hepaLlLls recurs aL age 20Ŵ30Ť lL can lead Lo
cancer of Lhe llver
AkAŴ Ln1L8lC PLÞA1l1lS
CausaLlve AgenLŴ PepaLlLls L vlrus
Mode of 1ransmlsslonŴ lecalŴ Cral
Þredlsposlng facLors and lncubaLlon perlodŴ
same as hepaLlLls A
ManlfesLaLlon / Slgns and SympLoms
ÞreŴ lcLerlc sLage
leverţ body malalse (due Lo lnablllLy of he llver
Lo converL glucose Lo glycogen)
WelghL loss
Anorexla and vomlLlng (due Lo lnfllLraLlon and
lnflammaLlon) 8uC
Anemla (due Lo decreased llfespan of 88CsŴ
normal llfe span of 88C ls 120 days)
ManlfesLaLlon / Slgns and SympLoms
lcLerlc SLage
!aundlceŴ due Lo excesslve blllrubln ln Lhe blood
ÞrurlLus (lLchlness) Ŵdue Lo blle salLs ln Lhe
sweaL
1ea colored urlneŴ due Lo excess blllrubln ln Lhe
kldneys
Alcohollc (grayŴcolored) sLools
PepaLomegaly
ÞosLŴlcLerlc sLage
Slgns and sympLoms subslde
1ake 3Ŵ4 monLhs for Lhe llver Lo regeneraLe

dlagnosLlc/laboraLory exams
Llver funcLlon LesL/ llver enzyme LesLŴ Lo
deLermlne Lhe exLenL of llver damage
Alanlne Amlno 1ransfase (AL1)Ŵ 1sL Lo lncrease
when Lhere ls llver damage
AsparLaLe Amlno 1ransferase (AS1)Ŵ SCC1
Alkallne ÞhosphaLase (ALÞ)Ŵ Serum AnLlgen
AnLlbody 1esLŴ for hepaLlLls
PbsAgŴ surfaceŴ surface AnLlPAv
aŦ lgC
bŦ lgM
PbsAgŴ surface AnLlP8s
PbeAgŴ proLeln lndependenLŴ AnLlP8e
PbcAgŴCare lndependenL AnLl Pbc
PcsAgŴ Surface lndependenL AnLlPCs
dlagnosLlc/laboraLory exams
ulLrasound
Llver blopsy
urlnalysls

ManagemenL
ÞrevenLlonŴ lmmunlzaLlon for hepa A and 8
ConLrolŴ avold mode of LransmlsslonŤ
handwashlng
nurslng Care
CompleLe bed resLŴ Lo faclllLaLe llver
regeneraLlon
uleLŴ Lo promoLe Llssue repalr
Low faLţ hlgh carbo (CPC)ţ hlgh proLeln (CPCn)Ŵ
lf wlLh Slmple PepaLlLls
Low faLţ hlgh CPCţ low CPCnŴ lf wlLh Severe
PepaLlLls

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